Psychotherapy helps provide the space for us to pay attention to ourselves, regulate anxiety, and face the underlying mixed emotions that drive it.

Because anxiety is distressing, most people try to avoid it but then our brains don’t learn how to cope with anxiety and it ends up being in the driver seat of our lives.

Listening to anxiety is a path to resolve the underlying emotional conflict that drives it.

Austrian Psychiatrist and the ubiquitous father of psychology, Sigmund Freud, was the first to explain anxiety as a signal of an underlying emotional conflict. Freud asserted that anxiety occurs when experiences, feelings, and impulses that are too threatening to be known, such as core feelings like anger, rage, fear, sadness, guilt, love, happiness, and excitement, get suppressed out of our conscious awareness.

What Anxiety Is, and What It’s Not

Anxiety is not a thought in the mind. 

The circuitry that determines how anxiety discharges in the body is a bio-physiological pattern mediated by the somatic and autonomic nervous systems. 

When anxiety discharges through the somatic nervous system, voluntary muscles like those in the jaw, chest, and shoulders tense up. This type of anxiety is more tolerable than anxiety generated through the autonomic nervous system (ANS). When anxiety goes through the sympathetic branch of the ANS, one can expect symptoms like dry eyes, mouth and throat, and a tension headache. Anxiety recruited by the parasympathetic nervous system can feel like nausea, migraines, and dizziness. Foggy thinking, visual blurring, ringing in the ears, or tunnel vision occurs when anxiety hits the brain, which is known as cognitive perceptual disruption.

Anxiety and Fear Are NOT the Same. 

Fear is the core emotion that helps us to respond to an external threat. 

Anxiety is triggered by unconscious feelings that we learned were dangerous to feel and express because they threatened our bond with our caregivers. 

Listening to anxiety is a path to resolve the underlying emotional conflict that drives it.

A client of mine, Sylvia, had lots of mixed feelings toward her mom for staying with an emotionally abusive partner.  As a teen, Sylvia knew that she needed to protect her Mom from becoming overwhelmed, so she hid her struggles with depression and anxiety. In therapy Sylvia could safely access her anger and sadness, as well as the confidence and motivation to go back to school and study for her dream job as an architect.

Our core feelings give us real data about what we want and need, and what’s missing or unacceptable to us. They connect us with our emotional truth in the moment, and empower us to take appropriate action.

Not All Anxiety is Bad

Because all learning involves facing what we fear, a certain amount of anxiety is needed for new learning. 

If anxiety is too low, we can’t learn. If anxiety is too high, the brain cannot function. 

In her book, Run Towards the Danger, Sarah Polley describes her journey to resolving her debilitating concussion symptoms. Her doctor, concussion expert and Director of the University of Pittsburgh Medical Centre, Michael “Micky” Collins tells her to “run towards the danger”. Instead of seeing her symptoms as something to be avoided, Dr. Collins educates Polley to see her symptoms as opportunities to increase her threshold of anxiety tolerance. 

The same principle that Polley learned in her concussion treatment program applies to psychotherapy work: when we avoid doing things to avoid feeling anxious, our brains don’t learn how to cope with the anxiety, and the anxiety ends up being in the driver seat of our lives.

Anxiety is helpful when it helps us scan the environment and assess for danger. Feeling anxious while walking through an underground parking lot at night helps us to be alert and move quickly. Similarly, adrenaline at a job interview or while doing a presentation can actually help improve focus, and sharpen the senses.

When anxiety is maladaptive, our appraisal of imminent danger is exaggerated and distorted, and we can get stuck.

For example, a certain amount of anxiety about going on a date is understandable but when it hijacks a person’s ability to speak, and cripples their confidence to the degree that they avoid dating altogether, treatment is needed.

What ARE Core Feelings?

When people get hijacked by anger, or drowned in sadness, they are not actually online with their core feelings. 

Being able to feel anger in a healthy way helps us make good choices about how and when to be assertive and set appropriate boundaries. 

The core feeling of sadness gives us a path to be kind and compassionate toward ourselves. Not so when self defeating thoughts like “I’ll always be alone” and “I’ll never be good enough to get my Dad’s approval”, take over and drive more anxiety, and even depression . 

Access to our core emotions is only possible when we can slow down and pay attention to ourselves. This is a skill we need to learn from our parents. Children who grow up securely attached with their parents know that their parents care about their feelings, and have the capacity to be present with them. 

A parent who can’t bear to say no to their child, and instead says yes to avoid the child having a negative reaction is role modelling low tolerance for their child’s anger and sadness. Being a loving parent often means saying no, and being consistent in providing appropriate consequences and healthy boundaries. When this emotional learning is lacking, psychotherapy can provide help for adults who struggle with managing anxiety and feelings in their intimate relationships.

Anxiety is a signal that unresolved feelings are getting stirred up. Psychotherapy helps provide the space for us to pay attention to ourselves, regulate anxiety, and face the underlying mixed emotions that drive it. In our distracted, instant gratification culture, paying attention to ourselves rather than ignoring and avoiding our discomfort can be challenging, but the payoff is greater confidence, self trust and self love. 


Frederickson, Jon, Byster, Diane, ISTDP Core Training materials.

Neborsky, Robert, J., and Lewis, Sharon. Understanding and effectively treating anxiety symptoms with psychotherapy. Healthcare Counselling & Psychotherapy Journal (HCPJ), Jan2011; 11(1): 4-8. (5p)